Provider Demographics
NPI:1679641997
Name:BONDHUS, JOHN B (PA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:B
Last Name:BONDHUS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-520-5476
Mailing Address - Fax:501-520-5486
Practice Address - Street 1:1662 HIGDON FERRY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6999
Practice Address - Country:US
Practice Address - Phone:501-520-5476
Practice Address - Fax:501-520-5486
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA202363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPA202OtherSTATE LIC. NUMBER
ARPA202OtherSTATE LIC. NUMBER